Multiple Broken Ribs and Asthma
I received a late-night phone call from another state that my family member had an accident and was in the hospital.
The next morning, Hubster and I flew to be by my family member’s side. The night nurse had given me the address of the hospital and instructions on how to get into the ICU.
I was shocked when I saw my family member. They were heavily sedated, on high-flow oxygen, an IV, and high doses of painkillers.
The day shift nurse gave me an update on my family member. He had broken 9 ribs – yes, 9 (all on the same side.) Most people are born with 12 ribs on each side. I was worried because he had broken 9 out of 12 ribs, all on one side. I also knew he had a flail chest.1
Flail chest happens during an accident when 3 or more adjoining ribs are broken and the ribs have 2 or more breaks. To visualize this, imagine the chest expanding out but the broken section of ribs sinking like an empty bowl. It's dangerous and can also be deadly.1
Broken ribs impacting asthma
The priority was his flail chest, but I knew that not being able to fully inflate his lungs could lead to pneumonia. Pneumonia is hard enough to battle when you have healthy lungs, but lung infections are always worse when you have asthma. Even though my family member was on high-flow oxygen, his oxygen level was too low and there was a chance they would intubate him (have a breathing tube placed down his throat to help him breathe.)
I asked the ICU doctor for an update, including how often my family member was being given breathing treatments. I also asked if they were they using just albuterol or an albuterol/ipratropium bromide combination. The doctor asked if I was a doctor, and I told her no, but that I worked in public health, was a certified asthma educator (AE-C), and was medically knowledgeable. So she explained his injuries and treatment plans.
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View all responsesAdvocating for loved ones in the hospital
Don’t be afraid to ask questions on behalf of your loved one when they are in the hospital. If they are sick or injured enough to be admitted to the hospital, they are usually too sick to advocate for themselves.
Once, when my daughter was very young, she was hospitalized with pneumonia (made worse because of her asthma.) The young respiratory therapist (RT) gave my daughter a nebulizer treatment, and I noticed her heart rate spiking and asked the RT what he put in her nebulizer. He had mistakenly given my daughter the adult dose instead of the child’s dose (and quickly ran out of the room when I questioned him.)
From that moment on, I have asked questions about treatments for my family members. What is that medicine for? What dose do you have? What should I watch for? What are the next treatment steps? What else do I need to know?
A long road to recovery
My injured family member spent time in the ICU, the regular hospital floor, and in a physical rehab facility. To treat the flail chest, they operated and put metal plates along the ribs to hold them together. Once his rib cage was stabilized, his care team was able to focus on breathing exercises to help my family member breathe a little deeper and prevent pneumonia.
You may have used an incentive spirometer for breathing exercises if you were in the hospital. It's a handheld unit that you use to inhale and try to keep the little ball in between the markers. It helps you strengthen and expand your lungs, and helps with secretions.2
It seemed to do the trick, and I would nag my family member to use his incentive spirometer. I told him his asthma was being cranky – but that would be nothing compared to pneumonia! He continued to use his controller inhaler for his asthma and grudgingly used the incentive spirometer.
It's been a long road, but my family member is finally on the mend. His lung capacity and asthma are both better, and I am relieved.
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